An incidental heavily calcified gallbladder is found on imaging. What is the recommended next step?

• A. Watchful waiting
• B. Laparoscopic cholecystectomy
• C. Endoscopic gallbladder removal
• D. Chemotherapy

Answer: (B)

A heavily calcified gallbladder seen on imaging is most concerning for a porcelain gallbladder, a condition in which the gallbladder wall becomes calcified due to chronic inflammation. This pattern carries a significantly increased risk of gallbladder carcinoma, so removing the gallbladder proactively is advised even if the patient has no symptoms.

Laparoscopic cholecystectomy is the preferred way to treat this because it provides definitive removal of the risk while offering the benefits of a minimally invasive operation. Watchful waiting would leave the cancer risk unaddressed. Endoscopic removal isn’t a standard option for removing the gallbladder, and chemotherapy is used for established malignancy, not as a preventive measure.